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Extravasation injury in a paediatric population
Adrian D Murphy1, Robert F Gilmour1, Chris J Coombs1
1Department of Plastic and Maxillofacial Surgery, Royal Children's Hospital, Melbourne, Victoria, Australia.
Insights
Extravasation injuries in children, especially neonates, can cause severe tissue damage. Prompt plastic surgery consultation and treatment are crucial to minimize long-term harm and improve outcomes.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Wound Management
Background:
- Extravasation, or drug leakage outside the vein, can cause tissue necrosis and morbidity.
- Neonates in intensive care units are highly susceptible, with up to 70% experiencing extravasation injuries.
- Plastic surgery is frequently involved in managing these pediatric injuries.
Purpose of the Study:
- To analyze the incidence, agents, treatments, and outcomes of extravasation injuries in children.
- To identify risk factors and inform management strategies for pediatric extravasation.
Main Methods:
- Prospective data collection over 18 months at a children's hospital.
- Inclusion of all extravasation injuries referred to the plastic surgery department.
- Documentation of the causative agent, treatment interventions, and patient outcomes.
Main Results:
- 43 extravasation injuries were recorded and managed by plastic surgery.
- 11% of patients (5/43) required surgical washout.
- 7% of patients (3/43) experienced significant tissue necrosis, delayed healing, and prolonged morbidity.
Conclusions:
- Infants in intensive care settings are at higher risk for extravasation injuries.
- Early referral and intervention are key to reducing tissue loss and morbidity.
- Optimizing management of pediatric extravasation can prevent severe complications.
Background:
Extravasation occurs when a drug is inadvertently administered outside of the vein. Depending on the substance involved, this may lead to tissue necrosis with significant long-term morbidity. Children, particularly neonates, are particularly susceptible to extravasation with up to 70% of children in neonatal intensive care unit having some form of extravasation injury. These injuries are commonly referred to plastic surgeons for ongoing management.
Methods:
We prospectively collected information on all extravasation injuries referred to the plastic surgery department in a children's hospital over an 18-month period. Data collected included the agent involved in the extravasation, treatment and outcomes.
Results:
In total, there were 43 extravasation injuries recorded on the hospital risk management system during the period of this study. All of these were referred to the plastic surgery team for ongoing management. Five patients (11%) underwent washout of their injuries. Three patients (7%) suffered injuries, which led to significant tissue necrosis, delayed healing and prolonged morbidity.
Conclusion:
Smaller infants, particularly those being cared for in an intensive care setting, are at increased risk for extravasation injury. Early referral and treatment of high-risk extravasation injuries may reduce the incidence of tissue loss and morbidity.
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